title: Excretion of West Nile virus in urine during acute infection.
abstract: Detection of West Nile virus (WNV) RNA in urine has been anecdotally described and proposed for the diagnosis of WNV infection. This study reports the routine use of real-time reverse-transcription polymerase chain reaction for the detection of WNV RNA in urine to support diagnosis of WNV infection during the large outbreak that occurred in northeastern Italy in 2012. Fourteen of 32 patients (43.8%) with symptomatic WNV infection, defined as neuroinvasive disease and fever, had detectable WNV RNA in urine at the time of diagnosis, at a higher rate and load and for a longer time than detection of WNV RNA in blood. Detection of WNV RNA in urine was less frequent (2 of 14 patients [14.2%]) in blood donors in whom WNV infection was identified by WNV nucleic acid amplification testing. Infectious virus was isolated from the urine of a patient with neuroinvasive disease and a high WNV RNA load in urine.
authors.affiliation: Department of Molecular Medicine, University of Padova, Padova, Italy. luisa.barzon@unipd.it
authors.forename: Luisa
authors.initials: L
authors.lastname: Barzon
authors.forename: Monia
authors.initials: M
authors.lastname: Pacenti
authors.forename: Elisa
authors.initials: E
authors.lastname: Franchin
authors.forename: Silvana
authors.initials: S
authors.lastname: Pagni
authors.forename: Thomas
authors.initials: T
authors.lastname: Martello
authors.forename: Margherita
authors.initials: M
authors.lastname: Cattai
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cusinato
authors.forename: Giorgio
authors.initials: G
authors.lastname: Palù
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001769:Blood / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D012367:RNA, Viral / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D014556:Urine / Q000821:virology*; D014773:Virology / Q000379:methods; D014901:West Nile Fever / Q000453:epidemiology / Q000821:virology*; D014902:West Nile virus / Q000302:isolation & purification*
chemical_list: D012367:RNA, Viral
keywords: West Nile fever; West Nile neuroinvasive disease; West Nile virus; blood donor; diagnostic accuracy; real-time RT-PCR; urine; virus isolation